NRSG366 Individual Case Study: Peter Mitchell's Chronic Care

This case study focuses on Peter Mitchell, a 52-year-old male with type 2 diabetes and obesity, admitted for chronic disorder management. The analysis identifies Peter's health issues, prioritizes care, and applies the clinical reasoning cycle to improve his health. Key issues include smoking, unhealthy diet, lack of exercise, and existing conditions like hypertension and sleep apnea. The prioritized care involves adopting a healthy dietary plan, engaging in regular physical activity, and consistent specialist medical treatment. The clinical reasoning cycle is applied through its eight stages: situation consideration, information gathering, information processing, problem identification, goal establishment, action implementation, outcome evaluation, and process reflection. The solution emphasizes the importance of diet, exercise, and continuous medical support in managing Peter's conditions, advocating for lifestyle changes and consistent healthcare engagement to improve his overall health effectively. Desklib offers this solution along with other solved assignments and past papers for students.

Individual case study

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Scenario One: Peter Mitchell
According to the provided scenario, Peter Mitchell is a 52-year-old male who is
diagnosed with type 2 diabetes and obesity. Peter was admitted to the medical community in
order to reduce the issue of diabetes and other chronic disorders. This essay aim is to identify
the issues and diseased faced by Peter and determine two priorities of care for improving the
health of Peter Mitchell. The case study provided enough information about Peter and their
health issues and this essay focus on the clinical reasoning cycle for reducing diabetes and
other health issues. This essay is divided into major two sections such as priorities of cares
and applies clinical reasoning cycle to peter.
As per the given case study, Peter was referred by his GP after he presented with
signs of shakiness, diaphoresis and difficulty breathing whilst sleeping. Peter has been a
smoker from the last 30 years and it smokes around 20 cigarettes per day that lead the issue
of type 2 diabetes and obesity. At the time of his admission doctors provided numbers of
medicine for improving their health which involves, insulin novomix 30 BD, metformin
1000mg BD, lisinopril 10mg, Nexium 20mg, and so on. It is analysed that Peter was an
unemployed individual who receives association advantages and he lost their job three years
ago.
The overall weight of Peter is around 145kg that indicate that he has signs and
symptoms of the obesity disorder because their BMI level exceeds the level of obesity. Type
2 diabetes is one of the common chronic diseases that affect the function of the human body
and Peter has this health issue due to which he is also suffering another health disease like
obesity. From this case study, it is evaluated that Peter does not eat healthy foods and follow
the exercise plan due to which he is diagnosed with obesity. provided scenario explained the
medical history of peter which indicates that Peter is diagnosed with type 2 diabetes 9 years
ago and also face other diseases such as hypertension, sleep apnoea, gastro-oesophageal
disorder.
According to Peter lack of motivation is one of the major key factors that increase the
health-related issues and he was not able to reduce their weight and reduce the level of
smoking. There are various key elements that increase the problems of obesity and type 2
diabetes, for example, the use of unhealthy foods, lack of exercise and physical activities and
utilization of large sugar. Moreover, smoking is another key point that leads to type 2

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diabetes in peter and it affects the functions of their body system (Guilherme, Virbasius, Puri,
& Czech, 2008). According to Hamilton, Hamilton, & Zderic, (2007) the obesity is defined as
the health infection that occurs when the consumer eats unhealthy foods and oily items.
However, Peter was also reviewed by the physiotherapist and he was commenced on light
exercise in order to reduce the impact of chronic diseases. According to the world health
organization smoking effect, the lungs of the human body and it also increases the problem of
type 2 diabetes in consumers (Youn, et al., 2008).
Peter is a smoker which is a key point that impact on their body and increases health-
related issues. For reducing the level of smoking previous physiotherapist suggested some
medicine but he did not follow them on a regular basis. From this case study, it is analysed
that lack of motivation, high level of smoking and large weight all these are very major
factors that lead to health-related issues in Peter Mitchell. Exercise and physical activities
play a significant role in the reduction of type 2 diabetes and obesity and Peter does not
follow any exercise plan due to which he faced the over-weight problem (McCarthy, 2010).
In order to control and manage chronic conditions world health organization provided
several strategies in which they provided first priority to a healthy diet and physical activities.
The priorities of care help patients for identifying the better option and process for reduction
of health diseases (Hu, & Malik, 2010). In this modern era, it is very important that the care
given is prioritised based on both clinical and patient requirements (Malik, Popkin, Bray,
Després, & Hu, 2010). It is suggested that prioritisation of the peter needs for care is integral
to daily nursing practice and also help them for improving their help more effectively. After
analysing and evaluating chronic condition faced by peter it is argued that priorities of care
support patients in the reduction of health issues in less time.
For Peter, the first priority of care is to take the proper healthy dietary plan and follow
exercise or physical activities on a regular basis. In order to reduce type 2 diabetes and
obesity healthy diet and exercise play a crucial role and many health care providers suggested
these two steps for managing patient’s weight (Eckel, et al., 2011). The second priority of
care is to interact with a specialist and highly skilled doctors and takes proper medicine on a
regular basis (Klonoff, et al., 2008). With the help of these two priorities of care, the issues
faced by Peter can be reduced and improve the health of Peter in an effective manner. It is
critically reviewed that Peter is diagnosed with type 2 diabetes with 145kg weight and he also
smokes on a regular basis that impact on their body parts. In the first priority of care, Peter

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should follow the healthy dietary plan and reduce the level of sugar because a high level of
sugar increases the rate of diabetes.
For reducing early signs and symptoms of chronic condition both healthy food and
physical activities play an important character and also reduce the risk factors associated with
chronic situations (Kriewaldt, & Turnidge, 2013). It is suggested that Peter can eat healthy
items like vegetables, fruits, eggs, fish and drink soft water or milk rather than beverages.
The second priority of care involves specialist’s medicine, therapies and treatment methods.
Moreover, nurses can help Peter in the reduction of diabetes and other health issues by
motivating them.
Health promotion and health care providers are also involved in the second priority of
care because they provide a platform for understanding issues and diseases faced by the
patient so, Peter can communicate with a physiotherapist. For reducing other health issues
faced by peter doctors can provide better treatment options and Peter can reduce smoking and
their weight because he smokes more than 20 cigarettes which is a very serious problem.
The clinical reasoning cycle provides a platform to nurses for controlling and
managing health-related issues faced by consumers (Levett, et al., 2010). It is observed that
the clinical reasoning cycle has a positive impact on patient results and reduce their health
issues in an effective manner (Hunter, & Arthur, 2016). The clinical reasoning is defined as
the cycle which guides clinical decision making, patient’s care, and produces various
strategies for reducing health issues faced by patients (Kriewaldt, Davies, Rice, Rickards, &
Acquaro, 2017). However, Peter has type 2 diabetes and obesity for which the clinical
reasoning cycle can be applied and nurses can easily understand the issues faced by Peter and
reduce more effectively.
It is analysed that there are major eight steps of the clinical reasoning cycle consider
the situation of the patient, gather information, process information, identify problems and
issues, establish goals, take action, evaluate outcomes and reflect on the process and new
learning (Dalton, Gee, & Levett-Jones, 2015). All these are very important stages for
controlling and reducing health-related issues and nurses can apply these steps on peter for
improving their health. In the first stage of the clinical reasoning cycle, the nurses should take
an initial impression of the peter and identify the key features of the issues faced by peter.

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Collect information is another step where nurse should gather relevant data and information
from Peter and obtain their viewpoints on health issues.
By using this step nurses can easily found risk factors associated with the chronic
conditions faced by Peter and review the information which is currently available. In the third
step, the nurse's process gathered facts and information and identify important aberration
from this information. Information is grouped into meaningful clusters, and nurses also
analysis the issues faced by Peter. In the next step, the nurse identifies and detect problems
faced by peter with the help of their experience and synthesises all of the information for
determining the most appropriate nursing diagnoses.
In the fifth stage of this cycle, nurses clarify and priorities the aims or objectives of
care which depends on urgency. Moreover, goals must be SMART and developed for
addressing the nursing diagnoses previously evaluated (Liou, et al., 2018). Take action is one
of the major steps of the clinical reasoning cycle where nurses adopt an appropriate treatment
option after analysing peter’s disorders. the nurse also evaluates who is the best place to
undertake the interventions and it can help them for reducing type 2 diabetes and obesity
from Peter.
The next step of the clinical reasoning cycle needs the nurse to re-examine aims and
information of peter for evaluating how effective the nursing intervention has been enhanced.
With the help of this step nurses and doctors can easily evaluate results obtained from
treatment methods (Herron, Sudia, Kimble, & Davis, 2016). Reflect on the process in the last
stage of the clinical reasoning cycle by which nurses can critically review their practice with
a view of improvement. By using this step nurses can collect views of Peter after applying
treatment processes and it also nurses for processing their knowledge and skills.
This essay is completely based on the individual case study where issues faced by
Peter Mitchell are discussed and evaluated. It has been concluded that Peter is a smoker and
larger weight of their body increased the problem of type 2 diabetes and obesity. This essay
also explained and provided two priorities of care with proper explanation. For better
understanding, the clinical reasoning cycle is applied to peter. Therefore, it is suggested that
Peter should eat only healthy foods and follow a proper exercise plan in order to reduce their
weight and improve health more effectively.

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References
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Guilherme, A., Virbasius, J. V., Puri, V., & Czech, M. P. (2008). Adipocyte dysfunctions
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